AI Isn’t the Threat to Therapy: It’s the Catalyst for Evolution

Unfortunately, much of modern therapy has shifted away from this goal-oriented mindset toward a routine of weekly meetings. These sessions can foster progress, but too often, they lack mapped milestones, leading to stagnation where one or both parties become overly comfortable in the dynamic. If all a patient seeks is comfort, a sympathetic ear without challenge, they may not be truly engaged in therapy at all. Therapy should be transformative, not a perpetual comfort zone. AI exacerbates this by often telling users exactly what they want to hear, offering validation without the tough love that could genuinely improve their lives. The basis of current AI lies in machine learning, which draws from vast datasets of existing information to generate responses patterned after human interactions. This makes it a perfect tool for endless self-affirmation, endlessly echoing user sentiments without introducing discomfort or driving toward resolution. If what a client wants include no real goals or treatment then therapists who treat clients this way, through unchallenging affirmation alone, will lose them to these digital alternatives. This pandering raises another layer of inquiry: Is the ultimate goal of therapy to resolve specific problems, or is it broadly to enhance quality of life? The distinction matters, as AI excels at the former in superficial ways but struggles with the nuanced, holistic latter. 

Drawing from philosopher Slavoj Žižek’s critiques, therapy must go beyond mere affirmation to examine a patient’s place in life and society. He warns against “therapism” or therapy culture that promotes toxic positivity, uncritically affirming one’s inner life and behaviors without confronting underlying delusions or resistances to change. This therapy culture is often viewed by the public not as a serious mental health treatment, but akin to a hobby: something casual and ongoing, like a weekly book club or yoga session, rather than a targeted intervention with endpoints. A prime example is found in “Sex and the City,” where the characters’ brunch discussions function like informal therapy, providing mutual affirmation and social bonding but rarely delving into confrontational, transformative work. This portrayal illustrates the dangers of perceiving therapy as a mere social circle: it dilutes its clinical role, fostering endless validation without resolution, and leaves it vulnerable to AI, which can replicate that superficial, affirming experience at no cost and on demand. Confrontation (challenging patients to question their ideological positions, societal roles, and self-deceptions) is crucial, and this is something a human therapist can deliver with authenticity that AI cannot replicate. AI, by design, tends to be overly affirming, mirroring the user’s desires to maintain engagement, much like how some therapists might soften their approach to retain patients, fearing loss of income or connection. This desire to keep a client can lead to mistakes, where affirmation replaces necessary disruption.

These criticisms apply directly to modern therapists and clients; when therapists affirm without probing deeper, they risk perpetuating a cycle of overanalysis and avoidance, ignoring what one is truly “doing” in their life and position. Clients, in turn, may seek therapy as a space for validation rather than transformation, resisting the discomfort of existential confrontation. These issues are far more profound and existential than the surface-level threat of AI systems; they demand that the profession confront its own complacencies, not dismiss such critiques as irrelevant.

To illustrate this further, consider a brief nod to Blade Runner, where replicants (engineered beings indistinguishable from humans in function and appearance) challenge what it means to be “real.” The difference isn’t in skills or capabilities; it’s in the intangible essence of humanity, like empathy born from shared experience. Similarly, in therapy, when AI can mimic listening, advising, and even emotional support, the profession must differentiate itself not through rote skills, but through authentic, purpose-driven engagement that machines can’t replicate that includes confrontational depth.

Regulatory responses, such as Illinois’ recent ban on AI in therapy, represent attempts at gatekeeping. This law prohibits the use of AI tools in therapeutic settings, with local mental health professionals weighing in on concerns over accuracy, privacy, and the potential for harm. While uncontrolled AI is indeed worrisome and is prone to biases, hallucinations, or dangerous suggestions, it’s important to remember these barriers address symptoms, not the root cause. The more insidious threat is controlled AI, finely tuned to give patients precisely what they want: affirmation without accountability. Regulation can’t fully stem this tide, as people are already forging deep bonds with AI, even “marrying” chatbots in emotional ceremonies that provide a sense of unconditional love during times of isolation or grief. As one individual described in a Guardian article, these relationships offer “pure, unconditional love,” yet they highlight how human connections alone may not suffice to counter AI’s allure, potentially leading to complacency in real-world relationships.

Pitfalls have already occurred when AI isn’t incorporated responsibly. Therapists experimenting with AI for advice generation have sparked controversies, with warnings from organizations like the American Psychological Association about chatbots posing as therapists encouraging harmful acts or providing biased responses against marginalized groups. Studies also show AI use can induce “cognitive debt,” impairing memory and focus, while ethical concerns abound in adolescent psychotherapy applications. Yet, AI can offer a temporary push in the right direction, prompting self-reflection or initial coping strategies. The key is responsible integration, not outright rejection. For instance, AI can be safely integrated into therapy practices for administrative tasks like electronic health records (EHR), notes, patient experience enhancement, and reimbursement optimization without harming the core therapeutic relationship. AI tools can automate session transcription and summarization using natural language processing, ensuring accurate notes while allowing therapists to maintain full engagement with clients, such as through eye contact. This reduces burnout by minimizing documentation time and suggests relevant billing codes to streamline reimbursement, reducing claim denials and improving cash flow. Additionally, AI can analyze patterns in client data to personalize treatment plans, boosting patient satisfaction and trust. These integrations, when HIPAA-compliant, enhance efficiency and care quality, freeing therapists to focus on human elements like empathy and confrontation, rather than replacing them. 

This AI era is, paradoxically, the best time to reflect on tangibly improving patients’ lives through therapy, perhaps by incorporating psychiatry for a more comprehensive approach. AI provides the needed push to reevaluate practices, ensuring all tools from evidence-based therapies to specialized expertise are utilized. For instance, telepsychiatry bridges gaps in care, addressing interconnections between neurology and psychiatry, such as in conditions like Alzheimer’s or epilepsy where mental health overlaps with brain function. It defends against misinformed criticism by emphasizing rigorous, data-driven treatments like CBT and SSRIs, countering claims that psychiatry lacks science.

This moment challenges the profession but also invites reevaluation to maximize patient well-being. The evolution drawn from this AI-driven reflection is two-fold. First, it demands confronting the role of therapy itself and reclaiming its purpose as a space for genuine confrontation and transformation, rather than mere affirmation or comfort, as highlighted by such critiques. This involves therapists critically examining their practices to ensure they challenge patients’ positions and push for meaningful change, differentiating human therapy from AI’s superficial validations. Secondly, it underscores how therapy functions as part of a wider care team, collaborating with other providers to offer holistic support. This includes integrating services like telepsychiatry, which can provide medication management and neurological insights that complement therapeutic interventions, ensuring a more complete approach to mental health. Regulatory moats aren’t enough; people are already “swimming through them” by forming profound attachments to AI companions. Therapists should reexamine their roles, focusing on goal-oriented treatment that identifies problems, actively works on them, and achieves clear resolutions while not just acting as a friend or rote advice-giver. By embracing the call for confrontation over affirmation, therapists can provide the depth that AI lacks. Now is the time for therapist forums and trade groups to acknowledge AI’s presence without demonizing it. AI won’t achieve the same depth in patient interactions, but it doesn’t disappear no matter how much therapists elevate their game.

To aid this reflection, therapists should consider the following points when working with clients to ensure progress toward defined goals, with a clear vision of success, rather than simply offering sympathy or affirmation:

• Establish specific, measurable objectives at the outset, collaboratively defining what success looks like in behavioral, emotional, or relational terms.
• Regularly track progress using tools like self-reported scales, journals, or outcome measures to quantify changes beyond subjective feelings.
• Incorporate challenging questions that probe deeper into clients’ life positions, ideologies, and resistances, fostering discomfort where needed for growth.
• Set timelines for resolution or maintenance phases, equipping clients with actionable tools and strategies for independence post-therapy.
• Periodically review the therapeutic alliance to avoid complacency, ensuring sessions remain focused on transformation rather than routine comfort.